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89 Cards in this Set
- Front
- Back
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restriction of air flowing OUT of the lungs
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OBSTRUCTIVE lung disease
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What is the normal FEV1/FVC ratio?
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~80%
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LOW FEV1, HIGH TLC, and an FEV1/FVC ratio <80% is characteristic of which kind of lung disease
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OBSTRUCTIVE
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What is the mainstay management of all obstructive lung disease?
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beta agonists +/- anticholinergics +/- oxygen
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2 classifications of Obstructive lung disease?
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COPD and Asthma
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The 3 types of COPD?
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chronic bronchitis
pulmonary emphysema bronchiectasis |
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Why isn't asthma considered a type of COPD?
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Because it is reversible
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What are the two major types of Pulmonary emphysema?
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Panacinar and Centrilobular
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What COPD is referred to as the "PINK PUFFERS"
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pulmonary emphysema
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Patients with this used pursed-lip breathing to establish PEEP and have a barrel chest
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Pulmonary emphysema
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This allows a patient with pulmonary emphysema to maintain maximum inflation of their alveoli
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PEEP -
positive end expiratory pressure |
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Which type of pulmonary emphysema is associated with alpha-1-antitrypsin deficiency?
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Panacinar
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"BLUE BLOATERS" are hypoxemic early in their disease and develop edema secondary to R-heart failure, what form of COPD do they have?
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chronic bronchitis
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The patient with a wet, productive cough, dyspnea, and rhonci on auscultaiton has which form of COPD?
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Chronic bronchitis
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A focal bronchial dilatation, usually accompanied by infection
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Bronchiectasis
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bronchiectasis, + situs inversus + male sterility + hearing deficits
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Kartagener syndrome
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bronchiectasis + malabsorption + gallstones
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Cystic fibrosis
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This obstructive lung disease has a low FEV which significantly increases after albuterol administration
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ASTHMA
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This is an IgE mediated response that results in expiratory wheezing
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Asthma
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What is found in the mucus of asthma patients?
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Charcot-Leyden crystals and Curschmann spirals
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What are the 4 types of Asthma?
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intrinsic
extrinsic exercise-induced drug-induced |
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What is the most common form of asthma
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Extrinsic - Type I hypersensitivity (IgE mediated)
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In this type of lung disease the patient is restricted from taking air IN
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RESTRICTIVE lung disease
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Is the TLC low or high in a restrictive lung disease?
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LOW
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A black patient with a (+) panda sign, dyspnea and night sweats probably has what?
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Sarcoidosis - restrictive lung disease
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What is the cause of Sarcoidosis ?
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Unknown
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diffuse injury to the endothelium of the lungs such as sepsis, heroin use, or aspiration of gastric contents results in what restrictive lung disease?
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Adult ARDS
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What 3 things is Adult ARDS characterized by?
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Pulmonary edema
Respiratory distress Hypoxemia |
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What can occur within 2-3 weeks of the initial endothelial damage of Adult ARDS?
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collagen accumulation resulting in SEVERE interstitial fibrosis
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What is an alternative name for Neonatal ARDS?
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hyaline membrane disease
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What is the cause of neonatal ARDS?
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insufficient surfactant (lecithin)
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This is the term for a baby born prior to 33-34 weeks gestational age
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PRETERM
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What is the L:S ratio in Neonatal ARDS?
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L:S (lecithin:sphingomyelin) ratie is <2.0
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This lung disease is caused by habitual inhalation of non-degradable irritants
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pneumoconiosis
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This type of pneumoconiosis is characterized by ferruginous bodies and affects mostly the lower lobes
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Asbestosis
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Asbestosis causes a markedly increased risk for what two things?
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squamous cell carcinoma of lung and malignant mesothelioma
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This results from chronic inhalation of coal dust
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Anthracosis - specifically Coal Worker's pneumoconiosis
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Coal Worker's pneumoconiosis resulting in bronchiectasis, severe restrictive lung disease, and right heart failure is called what?
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Black Lung Disease
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Which lobes of the lung does inhalation of beryllium affect?
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LOWER
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chronic inhalation of quartz affects the UPPER lung lobes and raises susceptibility to what?
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TB
Type of pneumoconiosis is Silicosis |
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Hypersensitivity pneumonitis due to inhalation of thermophilic actinomycetes from moldy hay
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Farmer's Lung
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Hypersensitivity pneumonitis from inhalation of bird droppings or feathers
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Bird Fancier's Lung
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Hypersensitivity pneumonitis from inhalation of thermophilic actinomycetes on moldy bagasse
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Bagassosis
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Hypersensitivity pneumonitis from in halation of mold on tobacco
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Tobacco Work's Lung
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"Honeycomb lung" is fatal within several years what is the name of the disease?
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Diffuse Idiopathic Fibrosis
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What are the risk factors for pneumonia? (6)
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Alcoholism, extremes of age, institutionalism, COPD, immune compromise, smoking
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This form of pneumonia rales +/- rhonchi on auscultation and peri-bronchial infiltrates on CXR and it is confined to those alveoli contiguous to bronchi
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Bronchopneumonia
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What are the 3 primary etiologic agents of bronchopneumonia ?
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Hemophilus
Pseudomonas Staphylococcus |
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This pneumonia is confined to the entire lobe; has dullness to percussion and consolidation in that lobe on CXR
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Lobar pneumonia
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What is the #1 cause of all pneumonia?
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Pneumococcus
also known as streptococcus penumoniae |
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What are the 2 eliologic agents that cause lobar pneumonia?
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pneumococcus (also known as streptococcus pneumoniae) AND Klebsiella pneumoniae
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Which agent responsible for Lobar Pneumonia will cause a SUDDEN onset with dyspnea, cough, fever, rigor
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Steptococcus pneumoniae
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Which agent responsible for Lobar Pneumonia will cause PROLONGED onset of progressive dyspnea, cough, and fever over days; symptomatic clue is currant-jelly sputum
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Klebsiella pneumoniae
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If a patient has CURRANT-JELLY SPUTUM which agent would you suspect?
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Klebsiella pneumoniae
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What is the 4 step process of pneumococcus in lobar pneumonia?
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1) Congestion
2) Red hepatization 3) Grey hepatization 4) Resolution |
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Which organisms causes Friedlander's pneumonia?
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Klebsiella pneumonia
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A patchy pneumonia of lower lobes bilaterally, with rales and patchy bilateral infiltrates on CXR is which type of pneumonia?
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Atypical Pneumonia
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What are the top viral etiologies in atypical pneumonia? 3 in children and 2 in adults?
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Children: RSV, influenza, adenovirus
Adults: influenza A & B |
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What is the Eaton Agent ?
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Mycoplasma pneumoniae
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Aside from viruses what is the other primary etiologic agent that causes atypical pneumonia?
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Mycoplasma pneumoniae
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What is THE most common lung pathogen in ages 5-35, causing pharyngitis, bronchitis, and pneumonia?
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Mycoplasma pneumoniae
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What agent causes "Walking Pneumonia?
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mycoplasma pneumoniae
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What is the triad associated with "Walking Pneumonia" and what agent causes it?
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TRIAD: malaise, sore throat, and dry cough
agent: mycoplasma pneumoniae |
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This form of pneumonia causes unilateral patchy segmental or lobar alveolar infiltrate on CXR and is accompanied by high fever w/ relative bradycardia and DIARRHEA
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Legionnaire's DIsease
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What is the etiologic agent of Legionnaire's Disease?
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Legionella pneumonphila
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What are 3 causes of aspiration pneumonia?
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1) gastric acid
2) anaerobic bacteria 3) mechanical obstruction |
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acute onset; SOB, pink frothy sputum, bronchospasm, and cyanosis is usually due to aspiration of what?
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vomitus (gastric acid) during inebriation or drug overdose
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Insidious onset; cough, fever, purulent foul-smelling sputum is usually due to aspiration of what?
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gingival organisms in saliva secondary to decreased consciousness or decreased pharyngeal space/airway control
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Peptostreptococcus spp., bacteroides spp., and fusobacterium spp. are the most common bacteria to cause what type of pneumonia?
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anaerobic aspiration pneumonia
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70 - 90% of primary lung tumors are due to what?
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SMOKING?
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Hamartoma, adenoma, and leiomyoma are malignant of benign lung masses?
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BENIGN
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name the benign tumor of glandular structure or of glandular origin
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ADENOMA
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this tumor is due to anomalous development of tissue natural to a part or organ rather than a true tumor
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hamartoma
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benign tumor of smooth muscle
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leiomyoma
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name the specialized serotonin- & histamine-producing benign or malignant tumor arising usally from the GI mucosa
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Carcinoid
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If a carcinoid tumor metastasizes to the liver what do you get?
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carcinoid syndrome
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The flushing, diarrhea, bronchospasm, right heart valve lesions, and hypotension that may develop from metastasis to THIS ORGAN, cause WHAT SYNDROME?
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metastasis of a carcinoid tumor to the LIVER - develops CARCINOID SYNDROME
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How is the DX of Carcinoid Syndrome made?
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5'-HIAA (hydroxy indole acetic acid)
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What tests other than 5'-HIAA can be performed to DX carcinoid syndrome?
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Check VMA (vanillylmandelic acid); check metanephrins and normetanephrins
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What is typically the first symptom associated with a carcinoma?
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new onset cough or a change in the frequency of character of a pre-existing cough
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What are the 4 primary types of carcinoma?
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adenocarcinoma
squamous cell large cell small cell |
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This type of carcinoma is associated with a pre-existing lung scar and occurs in peripheral lung fields
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ADENOCARCINOMA
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Which two types of carcinoma occur in the area central to mediastinum
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squamous cell and small cell carcinomas
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This carcinoma may paraneoplastically produce PTH-like peptide
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Squamous cell carcinoma
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This carcinoma carries the WORST PROGNOSIS and may paraneoplastically produce ADH and ACTH
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Small cell carcinoma
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What carcinoma is also called oat cell carcinoma?
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Small cell carcinoma
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What autoimmune disease may small cell carcinoma cause ?
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Eaton-Lambert Syndrome - proximal muscle weakness, AB to presynaptic Ca channels on neurons of NMJ
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Small cell carcinoma may cause fluid overload and Cushing's syndrome due to paraneoplastically producing what 2 things?
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ADH and ACTH
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Any mass in the apex of the lung is termed WHAT and can cause what SYNDROME?
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Pancoast tumor can cause Horner's Syndrome
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